Provider Demographics
NPI:1538162771
Name:DOGGETT, WILLIAM HOWARD (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HOWARD
Last Name:DOGGETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 SALIDA SANDIA SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-7600
Mailing Address - Country:US
Mailing Address - Phone:505-873-8883
Mailing Address - Fax:505-884-0776
Practice Address - Street 1:3500 COMANCHE RD NE
Practice Address - Street 2:STE I
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4546
Practice Address - Country:US
Practice Address - Phone:505-884-0771
Practice Address - Fax:505-884-0776
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM823111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000K7052Medicaid
NMNM02K742OtherBCBS GRP. #
NM000K7052Medicaid